scholarly journals Development of web-based dynamic nomogram to predict survival in patients with gastric cancer: a population-based study

2021 ◽  
Author(s):  
Atefeh Talebi ◽  
Nasrin Borumandnia ◽  
Somayeh Abbasi ◽  
Hassan Doosti ◽  
Mohamad Amin Pourhoseingholi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Graphical Representation ◽  
Cox Model ◽  
Population Based ◽  
Individual Risk ◽  
Historical Cohort ◽  
Internal Validation ◽  
Web Based ◽  
The Individual ◽  
Gastric Cancer Patients

Abstract Gastric cancer (GC) is the fifth most frequent malignancy worldwide and the third leading cause of cancer-associated mortality. The study’s goal was to construct a predictive model and nomogram to predict the survival of GC patients. This historical cohort study assessed 733 patients who underwent treatments for GC. The univariate and multivariable Cox proportional hazard (CPH) survival analyses were applied to identify the factors related to overall survival (OS). A dynamic nomogram was developed as a graphical representation of the CPH regression model. The internal validation of the nomogram was evaluated by Harrell’s concordance index (C-index) and time-dependent AUC. The results of the multivariable Cox model revealed that the age of patients, body mass index (BMI), grade of tumour, and depth of tumour elevate the mortality hazard of gastric cancer patients (P < 0.05). The built nomogram had a discriminatory performance, with a C-index of 0.64 (CI: 0.61, 0.67). We constructed and validated an original predictive nomogram for OS in patients with GC. Furthermore, nomograms may help predict the individual risk of OS in patients treated for GC.

Differentiation of endemic areas by incidence rates of tick-borne infectious diseases as the basis for choosing prevention strategy and tactics

2019 ◽  
pp. 56-61
Author(s):  
N.V. Rudakov ◽  
N.A. Penyevskaya ◽  
D.A. Saveliev ◽  
S.A. Rudakova ◽  
C.V. Shtrek ◽  
...  
Keyword(s):  
High Risk ◽  
Infectious Diseases ◽  
Population Based ◽  
Preventive Therapy ◽  
Incidence Rates ◽  
Prevention Strategy ◽  
Individual Risk ◽  
The Individual ◽  
Integral Assessment ◽  
Very High

Research objective. Differentiation of natural focal areas of Western Siberia by integral incidence rates of tick-borne infectious diseases for determination of the strategy and tactics of their comprehensive prevention. Materials and methods. A retrospective analysis of official statistics for the period 2002-2018 for eight sub-federal units in the context of administrative territories was carried out. The criteria of differentiation were determined by means of three evaluation scales, including long-term mean rates of tick-borne encephalitis, tick-borne borreliosis, and Siberian tick-borne typhus. As a scale gradation tool, we used the number of sample elements between the confidence boundaries of the median. The integral assessment was carried out by the sum of points corresponding to the incidence rates for each of the analyzed infections. Results. The areas of low, medium, above average, high and very high risk of tick-borne infectious diseases were determined. Recommendations on the choice of prevention strategy and tactics were given. In areas of very high and high incidence rates, a combination of population-based and individual prevention strategies is preferable while in other areas a combination of high-risk and individual strategies is recommended. Discussion. Epidemiologic zoning should be the basis of a risk-based approach to determining optimal volumes and directions of preventive measures against natural focal infections. It is necessary to improve the means and methods of determining the individual risk of getting infected and developing tick-borne infectious diseases in case of bites, in view of mixed infection of vectors, as well as methods of post-exposure disease prevention (preventive therapy).

scholarly journals Survival Benefit of Adjuvant Radiation Therapy for Gastric Cancer following Gastrectomy and Extended Lymphadenectomy

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
R. A. Snyder ◽  
E. T. Castaldo ◽  
C. E. Bailey ◽  
S. E. Phillips ◽  
A. B. Chakravarthy ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Radiation Therapy ◽  
Gastric Adenocarcinoma ◽  
Survival Benefit ◽  
Cox Regression ◽  
Population Based ◽  
Adjuvant Radiation ◽  
Extended Lymphadenectomy ◽  
Factors Affecting ◽  
Gastric Cancer Patients

Purpose. Although randomized trials suggest a survival benefit of adjuvant chemotherapy and radiation therapy (XRT) for gastric adenocarcinoma, its use in patients who undergo an extended lymphadenectomy is less clear. The purpose of this study was to determine if a survival benefit exists in gastric cancer patients who receive adjuvant XRT following resection with extended lymphadenectomy.Methods. The SEER registry was queried for records of patients with resected gastric adenocarcinoma from 1988 to 2007. Multivariable Cox regression models were used to assess independent prognostic factors affecting overall survival (OS) and disease-specific survival (DSS).Results. Of 15,060 patients identified, 3,208 (21%) received adjuvant XRT. Adjuvant XRT was independently associated with improved OS (HR 0.67, CI 0.64–0.71) and DSS (HR 0.69, CI 0.65–0.73) in stages IB through IV (M0). This OS and DSS benefit persisted regardless of the extent of lymphadenectomy. Furthermore, lymphadenectomy with >25 LN resected was associated with improved OS and DSS compared with <15 LN or 15–25 LN.Conclusion. This population-based study shows a survival benefit of adjuvant XRT following gastrectomy that persists in patients who have an extended lymphadenectomy. Furthermore, removal of >25 LNs results in improved OS and DSS compared with patients who have fewer LNs resected.

CDK5RAP3 as a Novel Biomarker Signature Predicting Survival and Adjuvant Chemotherapeutic benefit in Gastric Cancer

2020 ◽  
Author(s):  
Jia-Bin Wang ◽  
You-Xin Gao ◽  
Ning-Zi Lian ◽  
Yu-Bin Ma ◽  
Ping Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Cox Model ◽  
External Validation ◽  
Tumour Tissue ◽  
Tissue Samples ◽  
Significant Difference ◽  
Validation Set ◽  
Gastric Cancer Patients

Abstract Background: We previously demonstrated that CDK5RAP3 acts as a tumour suppressor in gastric cancer through negative regulation of the Wnt/β-catenin signalling pathway, but its function in chemotherapeutic responsiveness of gastric cancer has not been investigated. In this study, we aimed to examine the clinical significance of CDK5RAP3 to predict chemotherapeutic responsiveness in gastric cancer.Methods: A collection of 188 pairs of tumour tissue microarray specimens from Fujian Medical University were employed for the discovery set, and 310 tumour tissue samples of gastric cancer patients were employed for the internal validation set. Eight-five tumour tissue samples from Qinghai University Hospital were used as the external validation set 1. Transcriptomic and clinical data of 299 gastric cancer patients from TCGA were used as the external validation set 2. CDK5RAP3 expression, microsatellite instability (MSI) status, and tumour-infiltrating lymphocytes (TIL) were examined with immunohistochemistry. Clinical outcomes of patients were compared with Kaplan-Meier curves and the Cox model.Results: In a multi-centre evaluation, increased CDK5RAP3 indication of better prognosis depends mainly on MSI-L/MSS status or TILhigh. High CDK5RAP3 expression predicts sensitive therapeutic responsiveness to postoperative adjuvant chemotherapy in gastric cancer. In a stratification analysis based on CDK5RAP3 combined with TIL or MSI status, patients with CKD5RAP3low TILlow showed no significant difference in prognosis after receiving chemotherapy, whereas patients with CKD5RAP3low TILhigh, CKD5RAP3high TILlow, and CKD5RAP3high TILhigh had better responsiveness to chemotherapy. In addition, patients with CKD5RAP3high MSI-L/MSS status benefitted the most from adjuvant chemotherapy among all patients evaluated. Conclusions: CKD5RAP3 can be used as an effective marker to evaluate individualized chemotherapy regimens in gastric cancer patients dependent on their TIL and MSI status.

scholarly journals Is There Any Role for Super-Extended Limphadenectomy in Advanced Gastric Cancer? Results of an Observational Study from a Western High Volume Center

2019 ◽  
Vol 8 (11) ◽  
pp. 1799 ◽  
Author(s):  
Maria Bencivenga ◽  
Giuseppe Verlato ◽  
Valentina Mengardo ◽  
Lorenzo Scorsone ◽  
Michele Sacco ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Observational Study ◽  
Advanced Gastric Cancer ◽  
Cox Model ◽  
High Volume ◽  
Median Number ◽  
D3 Lymphadenectomy ◽  
High Volume Center ◽  
Gastric Cancer Patients ◽  
Risk Of Cancer

Background: Although the Japan Clinical Oncology Group (JCOG) 9501 trial did not find that prophylactic D3 lymphadenectomy led to any survival advantage over D2 lymphadenectomy, it did find that the prognosis of subserosal and N0 gastric cancer patients improved. The aim of this retrospective observational study was to compare survival after D2 or D3 lymphadenectomy in different patient subgroups. Methods: The study considered all of the patients who underwent D2 or D3 lymphadenectomy at a high-volume center in Verona (Italy) between 1992 and 2011. After excluding patients with Bormann IV or neuroendocrine tumors, early gastric cancers, or non-curative resections, the analysis involved 301 R0 patients: 100 who underwent D2, and 201 who underwent D3 lymphadenectomy. Post-operative deaths and deaths due to recurrences were considered as terminal events in the survival analysis. Results: The D2 patients were significantly older than the D3 patients at baseline (69.8 ± 2.3 vs. 62.2 ± 10.7 years). The median number of retrieved nodes was 29 (interquartile range: 24.5–39) after D2, and 43 (34–52) after D3. The five-year disease-related survival rate was similar after D2 (44%, 95% confidence interval (CI) 34–54%) and D3 (41%, 34–48%) (p = 0.766). A Cox model controlling for sex, age, tumor site, Laurén histology, and T and N stages showed that the risk of cancer-related death after D3 was similar to that recorded after D2 (hazard ratio 0.97, 95% CI 0.67–1.42). There was a significant interaction between the T status and the extension of the lymphadenectomy (p = 0.012), with the prognosis being better after D2 in T2 and T4b patients, and after D3 in T3 patients. Conclusions: The findings of this study suggest that D3 lymphadenectomy is not routinely indicated for patients with advanced gastric cancer, although differences in survival after D3 across T tiers deserve further consideration.

scholarly journals POLYMORPHISM OF THE TP53 GENE IN PATIENTS WITH GASTRIC CANCER IN PROSPECTIVE AND CLINICAL CASE-CONTROL STUDIES

2018 ◽  
Vol 17 (3) ◽  
pp. 41-50
Author(s):  
A. V. Belkovets ◽  
S. A. Kurilovich ◽  
V. N. Maksimov ◽  
Yu. I. Ragino ◽  
L. V. Scherbakova ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Tp53 Gene ◽  
Population Based ◽  
Case Control ◽  
Case Control Studies ◽  
Serum Samples ◽  
Gastric Cancer Patients ◽  
Age And Sex ◽  
Development Of Gastric Cancer

Background.A functionally significant TP53Arg72Pro polymorphism can contribute to the development of gastric cancer (GC).The aim:to study the associations of genotypes and alleles of the TP53Arg72Pro 4 polymorphism with GC and biomarkers of gastric ucosal atrophy in population-based prospective and case-control clinical trials among the population of Siberia.Material and methods.As a part of the epidemiological study, data of the international multicenter HAPIEE project for 2003–05, based on a population sample of residents of Novosibirsk city (serum and  DNA samples) and data of the population-based registry of GC  (2012) were compared. Gastric cancer patients were matched by  age and sex to HAPIEE population controls. A total of 156 serum  samples (GC – 52, control – 104) and 146 DNA samples (GC – 50,  control – 96) were available for prospective analysis. DNA samples  from 80 gastric cancer patients (45 men and 35 women, mean age  61.0 ± 13.4 years) and from 87 age-and sex-matched controls were  analyzed. DNA samples from venous blood were genotyped  according to standard methods. Serum samples were tested using  diagnostic kit for enzyme-linked immunosorbent assays to determine the levels of pepsinogen I (PGI), PGII, PGI/PGII ratio, gastrin-17 and IgG antibodies to H. pylori.Results.No differences in genotype and allele frequencies of the TP53 gene between the case group and the control group were  found. A decreased frequency of the Pro allele in female gastric  cancer patients compared with controls indicated that the Pro allele  is protective against the development of gastric cancer, but this  effect was not observed in male patients. No associations of TP53  genotypes with the risk of diffuse or intestinal gastric cancer, as well  as with the age and sex of patients were found. A high frequency of  genotypes with the Pro allele in patients with stage III–IV gastric  cancer indicated the relationship between Arg/Pro TR53 and tumor  progression, in particular, the contribution of the minor Pro allele to  the unfavorable prognosis. A prospective study showed high risk of  reducing the level of pepsinogen for assessing predisposition to  gastric cancer.Conclusion.Two case-control studies (population and clinical) conducted in the Western Siberia found no relationship between the  TP53Arg72Pro polymorphism and the risk of gastric cancer. However, the TP53 genotype with a rare Pro allele was associated with atrophic gastritis and severity of gastric cancer.

scholarly journals Establishment and Evaluation of a Nomogram For Prediction of Peritoneal Metastasis in Gastric Cancer

2021 ◽  
Author(s):  
Jin Zheng ◽  
Weibin Shi
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Peritoneal Metastasis ◽  
External Validation ◽  
Carbohydrate Antigen ◽  
Internal Validation ◽  
Factors Affecting ◽  
Carbohydrate Antigen 125 ◽  
Distant Organ Metastasis ◽  
Gastric Cancer Patients

Abstract Background Peritoneal metastasis is a critical way of metastasis for gastric cancer, patients with which tend to have poor prognosis. Laparoscopy or laparotomy is still major approach to diagnose peritoneal metastasis presently. This study was aimed to explore the factors affecting peritoneal metastasis of gastric cancer and establish a nomogram to predict that preoperatively. Methods 1002 gastric cancer patients who underwent surgery without distant organ metastasis was collected in the study. The nomogram was built with variables selected by univariate logistical regression and LASSO, and evaluated with internal and external validation ROC curve.Results Three factors including carbohydrate antigen 125, carbohydrate antigen 242 and serosal invasion or not of primary tumor were enrolled in the nomogram. The AUC value was0.922 (95%CI 0.897~0.947) in internal validation and 0.934 (95%CI 0.852~1.000) in external validation. Conclusions This study developed a nomogram with risk factors easily accessible before surgery in patients with gastric cancer, which can predict the probability of peritoneal metastasis well and would be helpful for clinicians to make appropriate therapy strategies.

scholarly journals Effectiveness and Healthcare Cost of Adding Trastuzumab to Standard Chemotherapy for First-Line Treatment of Metastatic Gastric Cancer: A Population-Based Cohort Study

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1691
Author(s):  
Matteo Franchi ◽  
Roberta Tritto ◽  
Lorena Torroni ◽  
Chiara Reno ◽  
Carlo La Vecchia ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Growth Factor Receptor ◽  
Cost Effective ◽  
Metastatic Gastric Cancer ◽  
Population Based ◽  
Standard Chemotherapy ◽  
Epidermal Growth ◽  
Gastric Cancer Patients

A randomized clinical trial showed that trastuzumab, added to traditional chemotherapy, significantly improved overall survival in human epidermal growth factor receptor 2 (HER2)-overexpressing metastatic gastric cancer patients. This population-based study aimed at evaluating both the clinical and economic impact of trastuzumab in a real-world setting. By using the healthcare utilization databases of Lombardy, Italy, a cohort of patients newly diagnosed with metastatic gastric cancer during the period 2011–2016 was selected. Among these, patients initially treated with either trastuzumab-based chemotherapy or standard chemotherapy alone were followed up until death, migration in other regions or June 2018. Overall survival and average cumulative costs were estimated and compared between the two treatment arms. Among the 1198 metastatic gastric cancer patients who started therapy within six months after metastasis detection, 87 were initially treated with trastuzumab-based chemotherapy and 1111 with standard chemotherapy. Median overall survival and restricted mean survival were 10.2 and 7.4 months, and 14.9 and 11.4 months, respectively, in the two treatment arms. The adjusted hazard ratio of death was 0.73 (95% CI 0.57–0.93). The average per capita cumulative healthcare costs were, respectively, EUR 39,337 and 26,504, corresponding to an incremental cost-effectiveness ratio of EUR 43,998 for each year of survival gained. Our study shows that adding trastuzumab to conventional chemotherapy is effective and cost-effective.

Sign in / Sign up

Export Citation Format

Share Document